Literature about help-seeking behaviour in adolescents often refers to helping them finding help for mental health problems. We prefer to take a broader view of ‘help’ as any form of support or assistance that a teenager might need related to their parent’s mental illness.
This might include:
Emotional support to develop coping skills and build personal resilience.
Access to information about mental illness and the symptoms experienced by their parent.
Practical help with household tasks and other caring activities.
Extra support at school.
Support for challenging behaviour or family relationships.
Help for teenagers’ own mental health concerns.
Assistance to take time out or access respite.
In this context, help might include informal assistance from family and friends or assistance and support from providers in mental health, education or welfare services.
Stages of help-seeking
The stages of help-seeking are commonly defined as:
Identifying the need for help.
Deciding to seek help.
Finding and accessing the appropriate help.
Why it's challenging for teens
For teenagers in families where a parent has a mental illness, identifying the need for help can be especially challenging as they may perceive their own life as ‘normal’ and may not recognise that they have a need to seek help. The decision can also be affected by a range of concerns for both the teenager and the parent including concerns about confidentiality and stigma, and fears of the involvement by mental health or child protection services.
Service providers need to be aware that an initial request for help can be a particularly vulnerable moment for the teenager. The response they receive will often determine whether they continue to seek help and whether the help is accepted or not.
Accessing help is also often based on the willingness of the parent to allow and support their child’s efforts, as well as practicalities such as eligibility for services, location, transport and cost.
The 'Continuum of need'
Considering the degrees of the need for help can be a useful way to think about help-seeking by teenagers so that you can provide the right support at the right time.3
Is it part of your job to support the children of your clients?
The answer is - YES!
Numerous policy documents highlight that promoting mental health and the safety of children is everyone’s responsibility. Children of parents with a mental illness may have limited contact with adults who can facilitate and encourage them to connect with support services, meaning they may not identify or seek help until they reach crisis point.
Parents who have a mental illness say that support for their parenting and their family is a vital part of their recovery process therefore by helping their children you will also be helping your client and their whole family to be well.
Many adolescents who have a parent with a mental illness have a strong urge to talk to someone about their situation but at the same time fear rejection, stigma and ridicule if they talk to friends, family or teachers. Seeking help may feel like an admission of weakness or a betrayal of their ‘family business’. They worry that by engaging with services they may be seen as different or their ‘secret’ might be revealed to others outside their family.
Working with parents in a mental health setting gives you a unique opportunity to assist teenagers to seek help.
You can make your service an entry point for help-seeking by young people who are otherwise isolated and help parents learn how they can facilitate help-seeking by their children.
What about confidentiality?
Service providers may be unsure whether sharing information with their client’s children breaches confidentiality policies. Teenagers are also reluctant to seek help unless they can be certain that conversations will be kept confidential and some may prefer for their parents to not be informed.
Parents may have their own fears, including concerns that talking with health professionals may result in notification to child protection services. This is a challenging area as families may have had previous negative experiences that reinforce their fears and there will be situations when it is necessary to make a report.
You can help build trust and confidence by:
Informing young people and parents about s confidentiality and mandatory reporting policies.
Being transparent with families who seek help about the role of different services.
Assuring parents and young people that information will only be passed on if you have serious concerns for their safety or wellbeing.
permission to share information with their children and vice versa.
Talking with them about any hesitancies or concerns they may have.
1. Maybery, D.J., Reupert, A.E., Patrick, K., Goodyear, M., Crase, L., 2009, Prevalence of parental mental illness in Australian families, Psychiatric Bulletin [P], vol 33, issue 1, Royal College of Psychiatrists, UK, pp. 22-26.
2. Wilson, C.J. & Deane, F.P., 2001, Adolescent Opinions About Reducing Help-Seeking Barriers and Increasing Appropriate Help Engagement, Journal of Educational and Psychological Consultation, vol 12, issue 4, pp. 345-364. http://dx.doi.org/10.1207/S1532768XJEPC1204_03
3. Bannerman, N. & Falkov, A., 2009, Conceptual models – Part 1, approaches to practice, The Clinician Volume 4: ulnerable Families: Children of Parents with Mental Illness, p.77.